Comparative evaluation of F-18 FDOPA, F-18 FDG, and F-18 FLT-PET/CT for metabolic imaging of low grade gliomas

• Published in: Clinical nuclear medicine Vol. 34; no. 12; p. 878
• Main Authors: Tripathi, Madhavi, Sharma, Rajnish, D'Souza, Maria, Jaimini, Abhinav, Panwar, Puja, Varshney, Raunak, Datta, Anupama, Kumar, Nitin, Garg, Gunjan, Singh, Dinesh, Grover, Rajesh K, Mishra, Anil K, Mondal, Anupam
• Format: Journal Article
• Language: English
• Published: United States 01.12.2009
• Subjects: Adolescent; Adult; Brain Neoplasms - diagnosis; Child; Child, Preschool; Dideoxynucleosides; Dihydroxyphenylalanine - analogs & derivatives; Female; Fluorodeoxyglucose F18; Glioma - diagnosis; Humans; Male; Middle Aged; Positron-Emission Tomography - methods; Radiopharmaceuticals; Reproducibility of Results; Sensitivity and Specificity; Subtraction Technique; Tomography, X-Ray Computed - methods; Young Adult
• ISSN: 1536-0229
• DOI: 10.1097/RLU.0b013e3181becfe0

We undertook this prospective study to compare amino acid metabolism, glucose metabolism, and proliferation in primary and recurrent low grade gliomas using positron emission tomography (PET)/computed tomography with F-18 FDOPA, F-18 FDG, and F-18 FLT. Fifteen patients with newly diagnosed or previously treated low grade gliomas (WHO grade I or II) were subjected to F-18-FDOPA, F-18 FDG, and F-18 FLT PET/computed tomography studies on consecutive days. This included 2 patients in remission as control subjects. Uptake of all the 3 tracers were analyzed visually and quantified using standardized uptake values and tumor to normal (T/N) ratios. The accuracy of all the 3 PET tracers in the detection of newly diagnosed and recurrent low grade gliomas was compared. F-18 FDOPA was positive in all cases of primary and recurrent low grade gliomas and negative in the patients in remission. Tumor was visualized on F-18 FDG in 7 of 13 cases, F-18-FLT was positive in 4 of 13 cases. Average tumor standardized uptake values max for F-18 FDOPA (5.75 +/- 4.9) and F-18 FLT (1.8 +/- 0.91) was lower than that of F-18 FDG (8.5 +/- 4.4). T/N ratios for F-18-FDOPA (2.3 +/- 0.51) and F-18 FLT (1.8 +/- 0.91) were higher than F-18 FDG (1.03 +/- 0.64) providing good image contrast for tumor detection in positive cases. F-18 FDOPA scan is superior to both F-18 FLT and F-18 FDG for visualization of primary and recurrent low grade gliomas. F-18-FLT should not be considered for evaluation of recurrent low grade gliomas.